Best Positions for Early, Active, and Pushing Phases of Labor

There’s a reason birth educators and pelvic floor therapists talk so much about movement: labor is physical. And the position you choose can influence:

• Comfort (pressure, back labor, hip/pelvic pain)
• Energy conservation (so you don’t burn out early)
• Pelvic mechanics (how the pelvis opens in different ways)
• Baby’s ability to rotate and descend
• Your ability to relax the pelvic floor when it matters most

Here’s the key: there isn’t one “best” labor position. There’s a best position for you in that moment. Your goal is to match the position to the phase of labor you’re in.

Below are our go-to options for the early phase, active phase, and pushing phase, plus cues for when to switch.

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Phase 1: Early Labor Positions

Early labor goal: Rest, soften, conserve energy, and keep baby moving gradually.

What early labor positions should do

• Support rest between contractions
• Reduce tension in the jaw, ribs, hips, glutes, and pelvic floor
• Allow gentle movement without draining you

Best early labor positions to try

1) Side-lying (rest + recovery)

Helpful for: conserving energy, reducing pelvic floor clenching
How to set up:

• Pillow between knees; optional pillow behind your back
• Keep jaw and shoulders relaxed
• During contractions: inhale into ribs, long slow exhale

2) Supported forward-lean (counter/bed/partner)

Helpful for: easing back pressure, encouraging pelvic floor lengthening
How to do it:

• Lean into support with soft knees
• Let belly hang, drop shoulders
• Add gentle sway or hip circles

3) Birth ball sitting + circles

Helpful for: mobility with low effort, rhythmic coping
How to do it:

• Feet wide and grounded
• Circle hips or rock side-to-side
• Keep face soft and breathe steady

4) Hands-and-knees rocking

Helpful for: pressure relief, baby rotation support
How to do it:

• Hands under shoulders, knees under hips
• Rock hips back toward heels, then forward
• Relax neck and breathe wide into ribs

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Phase 2: Active Labor Positions

Active labor goal: Cope with intensity, stay supported, and create space for baby to descend and rotate.

What active labor positions should do

• Provide support + stability
• Encourage pelvic opening (symmetrical and asymmetrical)
• Offer options for back labor
• Help prevent burnout through position rotation

Best active labor positions to try

1) Standing sway (“slow dance”) with partner

Helpful for: gravity, rhythm, grounding

• Knees bent, hips heavy
• Sway side-to-side or in small circles
• Try firm hip/low-back pressure if it helps

2) Asymmetrical lunge (one foot up)

Helpful for: targeted pelvic opening + rotation support

• One foot on step/stool/curb
• Stay tall or slightly forward
• Switch sides every few contractions

3) Supported kneeling (upright or leaning forward)

Helpful for: tailbone relief + steady breathing

• Kneel on pillow/blanket
• Hug pillows on the bed or lean into partner support
• Keep hips heavy, thighs relaxed

4) Supported squat (use as a tool)

Helpful for: opening the pelvic outlet + gravity

• Hold a stable surface/partner support
• Use for 1–3 contractions, then switch to conserve energy
• Keep knees wide

5) Toilet sitting

Helpful for: pelvic floor relaxation and outlet opening

• Feet supported
• Lean forward slightly, relax your jaw
• Follow provider guidance for your situation/monitoring needs

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Phase 3: Pushing Positions

Pushing goal: Make space at the pelvic outlet, coordinate breath and pelvic floor, and protect tissues.

Best pushing positions to try

1) Side-lying pushing (controlled + tissue-friendly)

• Support top leg with pillows or partner support
• Think “long exhale, soften, open” instead of forcing

2) Hands-and-knees pushing

• Pillow under knees/wrists
• Hips heavy and wide
• Rest chest on pillows between pushes if needed

3) Supported squat / birth stool

• Use squat bar/partner support/stool
• Between pushes: relax face, shoulders, pelvic floor
• Switch out if legs fatigue quickly

4) Upright supported “throne” or kneeling

• Sit upright supported by pillows, knees wide
• Or kneel upright / lean forward with support

If you have an epidural

Depending on safety/monitoring, many people can still use options like side-lying, upright supported “throne,” and (sometimes) assisted hands-and-knees. Your nurse/provider will guide what’s appropriate.

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A simple position practice plan (10–12 minutes)

Practice 2–3x/week in late pregnancy (as cleared by your provider). Familiarity is the goal.

1. 3 minutes: Birth ball circles + long exhales
2. 2 minutes: Supported forward-lean sway
3. 2 minutes: Hands-and-knees rocking
4. 2 minutes: Side-lying relaxation breathing
5. 1 minute each side: Supported lunge

Breath cue: Relax your jaw on the exhale. A soft face often supports a soft pelvic floor.

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How pelvic floor therapy helps with labor positions (and recovery)

A Birth Preparation visit helps you connect mobility, breathing, pelvic floor relaxation, so you’re not learning it mid-contraction.

We will teach you:

• Hip and pelvic mobility for easier position changes
• How to reduce pelvic floor tension/clenching
• Breathing patterns for labor and pushing coordination
• Early postpartum recovery guidelines

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If you live in Central Texas, Book a Birth Preparation Appointment

Want a personalized plan built around your body, comfort, and birth preferences?

Strength & Dignity Wellness offers Birth Preparation appointments in:
Belton, Cedar Park, and Georgetown, TX

Book here

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Not local or prefer online support?

Join our self-paced, online program: Raise With Strength – Release for Labor

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Need a checklist for your go-bag?

Download our free guide: Labor Positions Checklist

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